Chronic venous insufficiencyArteries are vessels that bring oxygen-rich blood to the tissues; veins carry blood and by-products of the metabolism from the tissue to the heart. Varicose veins is a disease of surface veins. When the veins are no longer able to carry blood to the heart, you have chronic venous insufficiency (CVI).
There are three main types of veins: superficial veins that are just beneath the surface of the skin, deep veins that are between the muscles and perforator veins that connect the superficial and deep veins.
When you are in the upright position, blood in the veins is overcome by gravity on the way to the heart. In order for this to be possible, the muscles of the legs and feet must squeeze the deep veins. This way, blood flow to the heart is increased. The process of sending blood back to the heart is called the venous pump. When you walk and the muscles squeeze the veins, the venous pump is working well.
Symptoms of the disease
- swollen ankles,
- feeling of tension in the calves,
- feeling of heavy, aching and restless legs.
What are varicose veins?
Varicose veins are widespread, usually blue veins, which extend above the level of the skin. They can appear very winding. Larger varicose veins lead to skin changes. It usually starts out as the appearance of round, itchy lesions, which occasionally ooze. Changes continue in the dark colouration of the skin and subsequently in scabby skin, which mean one step to severely painful chronic wounds – hypostatic ulcers.
What causes chronic venous insufficiency (CVI)?
Chronic venous insufficiency is caused by numerous factors such as heredity, excess body weight, age, female sex, pregnancy, lack of exercise, smoking, prolonged sitting and standing positions.
CVI can affect anyone. Factors such as age and gender can additionally increase the risk of the development of CVI. It is most often experienced by women around the age of 50.
How do we diagnose CVI?
For the diagnosis of chronic venous insufficiency, mapping of the Duplex vein is usually carried out, through which the surface veins are evaluated in standard places. We also evaluate the transition of deep veins and potential blood flow in the wrong direction, towards the feet. The examination is painless and can be repeated.
How is CVI treated?
In the first phase, chronic venous insufficiency is not a disease that would affect your health. However, pain and swelling can contribute to reducing the quality of your life. In the first phase, the doctor dedicates the most attention to reducing pain and swelling. Later on, when changes in the skin develop and the disease is more serious, the need for treatment is urgent.
Types of treatment
- Compression therapy with socks:
the purpose is to compress the veins from the outside and prevent the flow of blood towards the ankles.
- Preventive measures:
it is recommended to rest with elevated legs and to avoid sitting and standing positions for lengthy periods of time. When we are forced to stand for longer periods of time, we should try to contract the calf muscles numerous times. This will direct the blood towards the heart and reduce swelling. We should try to maintain a suitable body weight or lose some weight if we are overweight.
- Sclerotherapy:
a chemical substance is injected into the vein, which causes inflammation within the vein. For this reason, the vein will begin to ache during the procedure; the vein has hardened and turned red. After a period of time, the vein is sealed and can no longer carry blood. The blood is directed to other veins in the area. The closed vein is absorbed by the body over time.
- Operational procedure:
The classical procedure refers to the removal of the entire vein. Because of preparation, several incisions are needed, especially in the inguinal region. Since the veins are removed from the subcutaneous tissue, the bruises are larger; there is more pain and the recovery period is longer. This method requires local or general anaesthesia, due to which hospitalization is usually extended to 2 days.
Endovenous laser or radio frequency therapy
Endovenous laser or radio frequency therapy refers to heat therapy for treating veins. Through heat, the vein shrinks and can no longer carry blood. As with sclerotherapy, the closed vein is absorbed by the body over time. The advantage of this method is rapid recovery. The patient will be able to stand on his feet immediately after the procedure.
He must wear applied compression stockings, which allow smooth movement. Normal movement is desired, with supported leg rest several times a day. There usually is not a great amount of pain, except for the feeling of stiffness in the thigh. This feeling occurs due to the shortened vein treatment. It is expected and does not pose any risks.
The method of treatment is agreed upon by the patient and doctor upon examination. The methods of treatment are tailored to each individual.
Remember: doctors treat diseases, which can be seen during the exam and are determined and conformed with an ultrasound. It is necessary to realize that the potential for the development of new varicose veins is still there and that the doctor cannot influence genetics. After treatment, there is much that you can do for yourself ...
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